At my baseline u/s for ivf I had 5 antral follicles on the R and 4 on the L. After stimming with follistim 375u for 5 days, I only have 3 follicles on the R between 8-11mm, and a bunch of small ones and no measurable follicles on the L, but a bunch of small ones as well. My estradiol was 239. My follistim was increased to 225u bid (450 total). I will go tomorrow for more bw and u/s, but I'm worried that this is not looking good for me. In your experience, do I still have a chance to respond or my cycle will most likely be cancel? I'm 39 y/o, this is my first ivf, I took OCP's for 6 wks, not on lupron and will use antagon. Thanks.

You may still have an adequate response. All you or your RE can do is see how things develope over the next few days. If you must cancel the cycle for poor response, ther are alternative protocols, or you can use an egg donor.Good luck.

Thanks Dr. Jacobs. I'm keeping my hopes up. What is the maximun follistim dose used. I have read that if one does not responds to 450u, there will hardly be any response to anything higher, but I have also hear of pts being on 300 bid and even 400u bid. Thanks again.